title: Randomized controlled trial comparing health-related quality of life in patients undergoing vertical scar versus inverted T-shaped reduction mammaplasty.
abstract: BACKGROUND
  There is controversy regarding the superiority of the vertical scar reduction technique versus the inverted T-shaped reduction technique for breast reduction surgery.
  
  
  METHODS
  Two hundred fifty-five patients were randomized to either the vertical scar reduction or inverted T-shaped reduction technique immediately before surgery over a 5-year period. Patients completed the Health Utilities Index Mark 3, Short Form-36, Breast-Related Symptoms Questionnaire, and Multidimensional Body-Self Relations Questionnaire at 1 week preoperatively and 1, 6, and 12 months postoperatively. Data were treated according to intention-to-treat principles. The primary outcome was the difference in the change in Health Utilities Index Mark 3 score from baseline to 12 months postoperatively between the two techniques.
  
  
  RESULTS
  Patients undergoing either technique gained a statistically significant and clinically important improvement from baseline to 1 year postoperatively in the Health Utilities Index Mark 3 (vertical scar reduction, 0.81, 0.16 to 0.87, 0.19; inverted T-shaped reduction, 0.79, 0.20 to 0.89, 0.15) and the Breast-Related Symptoms Questionnaire (vertical scar reduction, 50.26, 12.98 to 95.59, 9.36; inverted T-shaped reduction, 50.06, 12.50 to 94.09, 9.86). No difference in mean change in scores from baseline to 12 months postoperatively was seen in any of the quality of life questionnaires between the techniques.
  
  
  CONCLUSIONS
  There was a clinically important improvement between baseline and 1 year postoperatively in both groups in the Health Utilities Index Mark 3 and the Breast-Related Symptoms Questionnaire. The authors conclude that the techniques are similar when quality of life is the outcome of interest.
  
  
  METHODS
  Therapeutic, I.
authors.affiliation: Hamilton, Ontario; and Burnaby, British Columbia, Canada From the Division of Plastic Surgery, Department of Surgery, the Department of Clinical Epidemiology and Biostatistics, the Surgical Outcomes Research Center, and the Department of Psychiatry and Behavioral Neurosciences, McMaster University; and the Faculty of Health Sciences, Simon Fraser University.
authors.forename: Achilleas
authors.initials: A
authors.lastname: Thoma
authors.forename: Teegan A
authors.initials: TA
authors.lastname: Ignacy
authors.forename: Eric K
authors.initials: EK
authors.lastname: Duku
authors.forename: Robert S
authors.initials: RS
authors.lastname: Patterson
authors.forename: Arianna Dal
authors.initials: AD
authors.lastname: Cin
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Levis
authors.forename: Charles H
authors.initials: CH
authors.lastname: Goldsmith
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology / Q000601:surgery*; D002921:Cicatrix / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016462:Mammaplasty / Q000379:methods* / Q000523:psychology; D017060:Patient Satisfaction; D059035:Perioperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome